Epstein-Barr Virus Specific Antibody Response in Multiple Sclerosis Patients during 21 Months of Natalizumab Treatment

Abstract EN

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system.

Natalizumab, a humanized anti-α4 integrin monoclonal antibody, is a highly effective treatment approved for MS.

An association between MS and an exposure to Epstein-Barr Virus (EBV) sustained by the levels of antiviral capsid antigen (VCA) and anti-Epstein-Barr nuclear antigen-1 (EBNA-1) IgG has been described.

Our goal was to verify the utility of EBV-specific IgG as a marker in Natalizumab treated MS.

Twenty patients (17 female and 3 male) in treatment with Natalizumab were enrolled.

Serum levels of anti-VCA and anti-EBNA-1 IgG were determined and expressed as arbitrary units (AU) before treatment and every three months for 21 months of therapy.

Anti-VCA IgG levels were increased at the 15th month (235410 ± 196712 AU) comparing with the 3rd (98146 ± 47145 AU) and the 6th (109866 ± 52270 AU) months of therapy p<0.05.

No significant differences were found for serum anti-EBNA-1 IgG levels.

Our data indicate that a transient, self-limited, EBV reactivation can occur in MS during Natalizumab therapy but our results do not support the use of serum EBV-specific antibody levels as biomarkers for monitoring therapeutic response to Natalizumab in the course of MS.